F-calprotectin and blood markers correlate to Quality of Life in Pediatric Inflammatory Bowel Disease

OBJECTIVES: Our aim was to investigate predictors of Health Related Quality of Life (HRQoL) with respect to changes in disease parameters over time in children with Inflammatory Bowel Disease (IBD).

METHODS: This was a prospective longitudinal study examining the association between HRQoL (IMPACT III) and symptom scores (PCDAI, abbrPUCAI), fecal calprotectin (FC) measures and blood analyses (C-reactive protein [CRP], erythrocyte sedimentation-rate [ESR], orosomucoid [ORM], albumin [ALB], hemoglobin [HB] and vitamin-D [VIT-D]) in a cohort of 10-17 years old IBD patients. Data were collected prospectively at three-month intervals during a two-year period. Associations were analyzed using linear Mixed Effect Models. Patients were divided into two groups which received Non-biological oral treatment or Biological parenteral treatment.

RESULTS: From 79 patients (39 Crohn Disease [CD]/ 40 ulcerative colitis [UC]), representing a total of 43,132 days of observation, 572 IMPACT measurements were paired with variables. A decrease in the IMPACT III score was significantly associated with increased UC-symptom score in the Biological group (P = 0.005), and a similar inverse tendency was found in the Non-biological group and for CD-symptoms in both groups. We found in both treatment groups overall a significant (P < 0.05) inverse association between the IMPACT III and the levels of FC, ESR and ORM whereas ALB, HB and VIT-D were directly significant associated.

CONCLUSIONS: The IMPACT score, already known to correlate with disease activity, has now been shown to be associated with disease markers in feces and blood. This emphasizes that objective markers of disease activity indirectly can predict the patient's HRQoL.